Investigation of Malondialdehyde (MDA), Homocysteine (Hcy) and C- reactive protein (CRP) in sera of patients with Angina Pectoris


  • Ahmed Abduljalal Abduljabbar salahaddin universigty
  • Parween Abdulsamad Ismail salahaddin university



protein Angina Pectoris, Homocysteine, Malondialdehyde Keywords,


Homocysteine (Hcy) has been considered as an independent risk factor for coronary artery disease (CAD Oxidative stress and free radicals are known to have important roles in the development ofAngina Pectoris. Oxidative stress is present in cardiovascular diseases (CVDs), and hyperhomocysteinemia, an independent risk factor for these diseases, may play a role in inducing production of oxygen free radicals. The aim of this study was to determine a possible relationship between blood serum Hcy levels and lipid peroxidation in patients suffering from Angina Pectoris (AP).To evaluate the possible role of homocysteine (Hcy) in inducing oxidative stress in Angina Pectoris(AP), plasma homocysteine( Hcy), plasma malondialdehyde (MDA) and C reactive protein (CRP) were measured in 60 unstable Angina Pectoris patients, we tested 30 healthy volunteers. Hcy was measured by an enzymatic colorimetric method and MDA, an index of lipid peroxidation, by spectrophotometer. Serum Hcy levels were significantly higher in angina pectories (AP) patients than the controls (23.2±8.0 vs 10.76 ± 2.55 micromol/L; P <0.0001), Similarly, total MDA were significantly higher in angina pectoris (AP), patients than the controls (12.19 ± 0.68 vs 5.68 ± 0.45 nmol/L; P <0.0001).Our findings show that Elevated levels of tHcy and HsCRP appear to be associated with the pathogenesis of angina pectoris(AP).


Aamir M, Sattar A, Dawood MM, Dilawar M, Liaz A & Anwar M. (2004). Hyperhomocysteimia as a risk factor for ischemic heart disease. J coll physicians’ surg pak .14(9):518-21.

Angeline T, Aruna RM, Ramadevi K, Mohan G & Jeyaraj N. 2005. Homocysteine status and acute myocardial infarction among Tamilians. Indian Journal of Clinical Biochemistry. 20(1): 18- 20.

Austin RC., Lentz SR., Werstuck GH. ( 2004). Role of hyperhomocysteinemia in endothelial dysfunction and atherothrombotic disease. Cell Death Differ. 11 (suppl 1): S56–S64

Baby B, Saravanan G & Chinnaswamy P. 2009. Elevated concentrations of plasma homocysteine in coronary artery disease patients with normal folate level. Journal of Pharmaceutical Sciences and Research. 1(2):51-56.

Bragt PC, Bansberg JI, Bonta IL. 1980. Antiinflammatory effects of free radical scavengers and antioxidants. Further support for proinflammatory roles of endogenous hydrogen peroxide and lipid peroxides. Inflammation 4:289-99.

Berger HJ, Zaret BL, Speroff L, Cohen LS, Wolfson S. 1977. Cardiac prostaglandin release during myocardial ischemia induced by atrial pacing in patients with coronary artery disease. Am J Cardiol .39:481-6.

Berk B.C.WeintraubW.S. Alexander R.W. 2009. Elevation of C-reactive protein in active coronary artery disease Am J Cardiol .65 :168 - 172

Brown MS, Basu SK, Falcky JR, Ho YK, Goldstein JL.1980. The scavenger cell pathway for lipoprotein degradation: specificity of the binding site that mediates the uptake of negativelycharged LDL by macrophages. J Supramol Struct . 13:67-81.

Bukhari IH, Hassan MN, Haleem A, Bhatti MM.2005. Role of metals (Cadmium and lead) in patients of hypertension and their relationship with Ischemic Heart Disease. Res.J.Agric.&Biol.Sci. 1(2):190-94.

Cheeseman KH, Slater TF.1993. An introduction to free radical biochemistry. Br Med Bull.49:481–4938

Hajjar KA.2001 Homocysteine: a sulph’rous fire. J Clin Invest 107:663–664.

Coldea Agoston – Lucia., Teodora Mocan., Marc Gatfosse., Silvia Lupu., Dan L.Dumitrascu.2011. Plasma homocysteine and the severity of heart failure in patients with previous myocardial infarction, Cardiol J. 18 .(1): 55–62

Essawy F, Sayed AE, Madkour B, Hallouda M & Kheiry H. 2008. Prevalence of hyperhomocysteinemia in peripheral arterial disease: Atherosclerosis and arteritis. Research Journal of Medicine and Medical Sciences.3 (1): 76-83.

Flamm ES, Demopoulos HB, Seligman ML, Poser RG,Ransohoff J .1978. Free radicals in cerebral ischemia. Stroke ;9:445-7.

Fogelman AM, Shechter I, Seager J, Holom M, Child JS, Edwards PA.1980. Malondialdehyde alteration of low density lipoproteins leads to cholesteryl ester accumulation in human monocyte-macrophages. Proc Natl Acad Sci USA 77:2214-8.

Freimark D, Ami SB, Goldenberg I, Leor J, Doolman R, Novikov I, Eldar M &Hod H. 2003. Association of elevated homocysteine levels with a higher risk of recurrent coronary events and mortality in patients with acute myocardial infarction. Arch intern med. 163:1933- 1937

Juhan-Vague I. Alessi M.C. Joly P. Thirion X. 1989. Serradimigni plasma plasminogen activator inhibitor 1 in angina pectoris: influence of plasma insulin and acute phase response Arteriosclerosis . 9 :362- 367

Gryglewski RJ.1980. Prostaglandins, platelets and atherosclerosis. CRC Crit Rev Biochem .7 :291-338.Requests for reprints to: Dr Justo Aznar, Departamentode Biopatologia.

Guilliams TG. 2004. Homocysteine- A risk factor for vascular diseases: Guidelines for the clinical practice. The Journal of the American Nutraceutical Association.7(1): 11-24.

Knekt P, Reunanen A, Alfthan G, Heliovaara M, Rissanen H, Marniemi J & Aromaa A. 2010. Hyperhomocysteinemia a risk factor or a consequence of coronary heart disease. American medical association. vol.161:1589-1594.

Kontos HA, Wei EP, Poulishock JT, Dietrich WD, Magiera CJ, Ellis EF.2009. Cerebral arteriolar damage by arachidonic acid and prostaglandin G2. Science 209:1242-5.

Kuehl FA, Humes JL, Egan RW, Ham EA, Beveridge GC, Van Arman CG. Role of prostaglandin endoperoxide PGG2 in inflammatory processes. Nature 1977; 265:170-3

Liuzzo G. Biasucci L.M. Gallimore J.R. Grillo .1994. Prognostic value of C-reactive pr otein and serum amyloid a protein in severe unstable angina N Engl J Med :331 - 417 424

-Lubos, E., Lasclazo J. and Handy D.2007. Homocysteine and glutathione peroxidase-1. Antioxid. Redox, Signal. 1923-1940.

Mirhoseini SJ, Radmehr H, Sanatkarfar M, Froozan-Nia SKh, Salehi M,Alemohammad MGH, Bakhshandeh AR and Baalbaki M. 2008. Correlation between Total plasma homocysteine level and grading of coronary artery disease. Acta Medica Iranica. 46(2): 149-154.

Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M & Vollset SE. 1997. Plasma homocysteine levels and mortality in patients with coronary artery disease. The New England Journal of Medicine. 337: 230 -236.

Paswan S, Sharma RK, Gaur AR, Sachan A, Yadav MS, Sharma P et al.2013. Angina pectoris epidemic in India: a comprehensive review of clinical features, differential diagnosis, and remedies. Ind.J. Res.Pharm. & Biotech. 1(3):339-45.

Pasterkamp G, Algra A, Grobbee DE, Banga JD, van der Graaf Y. 2002. Homocysteine and the stage of atherosclerotic disease: A study in patients suffering from clinically silent and clinically manifest atherosclerotic disease. Eur J Clin Invest. 32:309–15.

Poddar R, Sivasubramanian N, Dibello PM, Robinson K, Jacobson D. 2001Homocysteine induces expression and secretion of monocyte chemo attractant protein-1 and interleukin-8 in human aortic endothelial cells: Implication for vascular disease. Circulation. 103:2717–23.

'Placer ZA, Cushman LL, Johnson BC. 1966. Estimation of product of lipid peroxidation (Malonyldialdehyde) in biochemical systems. Anal Biochem 16:359-64.

Rao HB, Govindaraju V & Manjunath CN. 2007.Risk prediction- homocysteine in coronary heart disease. Indian Journal of Clinical Biochemistry. 22(1):18-21.

Refsum H. (2002): Clinical Laboratory News May. 2-14.

Rowley KG, Diet AJLD, Cert DY AHW & O’Dea K. 2003. Homocysteine concentrations lowered following dietary intervention in any Aboriginal Community. Asia Pacific J Clin Nutr. 12 (1): 92-9540.

Shimizu T, Kondo K, Hayaishi 0. 1983. The role of prostaglandin endoperoxides in the serum thiobarbituric acid reaction. Arch Biochem Biophys 206:271-6.

Smith JB, Ingerman CM, Silver MJ. 1976. Malondialdehyde formation as an indicator of prostaglandin production by human platelets. J Lab Clin Med 88:167-72.

Sponder M, Szekeres MF, Marculescu R, Mittlböck M, Uhl M, Vallant BK et al. 2014. Blood and urine levels of heavy metal pollutants in female and male patients with coronary artery disease. Vasc Health Risk Manag 311:17-10

Stubbs PJ, Al-Obaidi MK, Conroy RM, MusB & collinson PO. 2000. Effect of plasma homocysteine concentration on early and late events in patients with acute coronary syndromes. American heart association. Circulation 102: 605-610.

Szceklik A, Gryglewski RJ, Domaglae B, et al. 1981. Serum lipoproteins, lipid peroxides and prostacyclin biosynthesis in patientswith coronary heart disease. Prostaglandins 22:795-807

Tappel AL. 1973. Lipid peroxidation damage to cell components. Fed Proc 32:1870-4.

Tavares JR, D’ Almeida VD, Diniz DC, Terzi CA, Cruz EN, Stefanini E, Andriollo, De Paola AAV & Carvalho AC. 2002. Analyses of plasma homocysteine levels in patients with unstable angina. (79):2.

Wald NJ, Watt HC, Law MR, Weir DG, McPartlin J & Scott JM. 1998. Homocysteine and ischemic heart disease- Results of a prospective study with implications regarding prevention. Arc.Iterm med.158(8): 862-867.

Wang G, Siow YL. 2001. Homocysteine induces monocyte chemoattractant protein-1 expression by activating NF-kappa B in THP-1 macrophages. Am J Physiol Heart Circ Physiol. 280:H2840–H7.

Wennmalm A, Chanh PH, Justand M. 1974. Hypoxia causes prostaglandin release from perfused rabbit hearts. Acta Physiol Scand 91:133-5.

Yadav AS, Bhagwat VR & Rathod IM.2006. Relationship of plasma homocysteine with lipid profile parameters in ischemic heart Dinajpur Med Col J 2013 Jan; 6(1) 53 disease. Indian journal of clinical Biochemistry. 21(1):106-110

Young PB, Kennedy S, Molloy AM, Scott JM, Weir DG, Kennedy DG. 1997. Lipid peroxidation induced in vivo by hyperhomocysteinaemia in pigs. Atherosclerosis 129:67–71.

Zhang D., Jiang X. and Fang P. 2009. Hyperhomocysteinemia promotes inflammatory monocyte generation and accelerates atherosclerosis in transgenic cystathionine betasynthase-deficient mice, Circulation. 120:1893–1902.

Zhong-qun Y, Goran KH. 2007. Innate immunity, macrophage activation and atherosclerosis. Immunol Rev. 219:187–203.




How to Cite

A. A. Abduljabbar and P. A. Ismail, “Investigation of Malondialdehyde (MDA), Homocysteine (Hcy) and C- reactive protein (CRP) in sera of patients with Angina Pectoris”, MJS, vol. 30, no. 1, pp. 68–74, Aug. 2019.



Chemical Science